Obamacare's little secret

Elizabeth MacDonough holds no elected office. Few people outside of Capitol Hill even know her name. And forget about knowing her political leanings or loyalties.

But she may very well be the most powerful person in Washington in determining how far Republicans can go in trying to repeal Obamacare.

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As the Senate parliamentarian, MacDonough will make the decisions on which pieces of the law qualify to be repealed using a complicated budget procedure called reconciliation. Her decisions would allow Senate Republicans to vote to kill major provisions of the health care law under a simple 51-vote majority without giving Democrats a chance to filibuster.

Republicans have not yet decided whether to use reconciliation — and whether to use it for Obamacare or tax reform. MacDonough would have a pivotal role in either scenario.

MacDonough started out as a Senate library clerk, moved up to become the “assistant morning business editor to the Congressional Record” and then, after law school, spent much of her working life in the nonpartisan parliamentarian office. She was named parliamentarian three years ago, the first woman to hold the position.

The parliamentarian is typically a little-known person — at most, MacDonough can sometimes be spotted on C-SPAN quietly advising the Senate’s presiding officer. But when the post has become controversial in the past, it’s often been over the thorny decisions around reconciliation.

Republicans protested decisions by then-parliamentarian Alan Frumin in the 2010 health care reform fight, when Democrats used the budget fast-track tool to pass a small part of the Affordable Care Act. In 2001, Republicans fired Robert Dove as parliamentarian after he ruled against them on how many reconciliation bills could be used. That was actually his second stint in the job: Democrats had fired Dove when they took the majority in 1987.

MacDonough doesn’t grant interviews or drop hints about how she might rule on Obamacare — or anything else, for that matter. Her tenure has been so free of controversy that many lawmakers interviewed said they didn’t know much about her, or even her name.

But those who do know her — Democrats and Republicans — describe her as even-keeled, friendly, smart and willing to listen.

Sen. John Thune (R-S.D.) said parliamentarians — or “parls,” as they’re known — have to make some tough calls that aren’t always black and white. “I think they do their best to use the facts and use the rules and follow the book,” he said. “She’s been around a long time, so she’s very steeped in the traditions of the Senate and understands how it works here. If and when the time comes, I’m sure she’ll be ready to do her job.”

Sen. Mark Warner (D-Va.) had a similar assessment: “I have no question about her ability to read the rules and make the right decisions.”

Those decisions are fought out in the so-called Byrd bath, the closed-door sessions when Republican and Democratic staff make their case to the parliamentarian about what goes in the bill and what stays out. It’s named for former Senate Majority Leader Robert Byrd, who created the complicated system years ago.

That process could significantly raise MacDonough’s profile if the Republicans use reconciliation for either tax reform or Obamacare. Both would be hugely controversial. President Barack Obama has repeatedly said he would veto any GOP bill that guts Obamacare.

But as Republicans consider reconciliation, they are also keeping an eye on 2016. They hope to win the White House then, and could go after the health care law in 2017 through reconciliation without a veto threat. Any decisions that MacDonough makes this year would set precedent for a second attempt at reconciliation two years from now.

“I think precedent of the past is going to dictate what gets in there, and the door is wide open right now,” Sen. Richard Burr (R-N.C.) said.

In the majority, Senate Republicans can try to overrule her decisions. They can even remove her from the job if they want.

“I would hope and trust that her reputation is a straight shooter, because she is,” Frumin said of MacDonough. “She’s a nonpartisan professional. She listens. She’s a very good listener. And she’s very smart. And she will have possibly some difficult decisions to make, but she’s absolutely the right person to do that.”

He knows the pressures firsthand. He approved most of what the Democrats wanted in reconciliation in 2010. It contained only a small part of the much larger bill that is Obamacare, but it was pivotal to getting the whole health care law passed.

Former Sen. Judd Gregg, the top Republican on the Budget Committee at the time, blames Democrats for “adulterating” the reconciliation process and said Frumin was put in “an impossible situation.”

“It’s unfair to put on the shoulders of the parliamentarian the outcome of the most significant public-policy initiative the president had,” he said.

But it’s not impossible that MacDonough could find herself in a similar role. Frumin said pressure is part of the job.

“Every generation or so this comes along,” he said. “But this is what the parliamentarian does.”